Abstract
Disparities in tobacco use and smoking cessation by race/ethnicity, education, income, and mental health status remain despite recent successes in reducing tobacco use. It is unclear to what extent media campaigns promote cessation within these population groups. This study aims to (1) assess whether exposure to antitobacco advertising is associated with making a quit attempt within a number of population subgroups, and (2) determine whether advertisement type differentialy affects cessation behavior across subgroups. We used data from the New York Adult Tobacco Survey (NY-ATS), a cross-sectional, random-digit-dial telephone survey of adults aged 18 or older in New York State conducted quarterly from 2003 through 2011 (N = 53,706). The sample for this study consists of 9,408 current smokers from the total NY-ATS sample. Regression methods were used to examine the effect of New York State’s antismoking advertising, overall and by advertisement type (graphic and/or emotional), on making a quit attempt in the past 12 months. Exposure to antismoking advertising was measured in two ways: gross rating points (a measure of potential exposure) and self-reported confirmed recall of advertisements. This study yields three important findings. First, antismoking advertising promotes quit attempts among racial/ethnic minority smokers and smokers of lower education and income. Second, advertising effectiveness is attributable in part to advertisements with strong graphic imagery or negative emotion. Third, smokers with poor mental health do not appear to benefit from exposure to antismoking advertising of any type. This study contributes to the evidence about how cessation media campaigns can be used most effectively to increase quit attempts within vulnerable subgroups. In particular, it suggests that a general campaign can promote cessation among a range of sociodemographic groups. More research is needed to understand what message strategies might work for those with poor mental health.
Highlights
Despite recent successes in reducing tobacco use, disparities in tobacco use and smoking cessation remain by race/ethnicity, education, income, and mental health status
Television viewing was higher among respondents with less education, lower income, and poor mental health
Regressions controlled for age (18–24, 25–39, 40–64, $65), gender, education, annual income (,$30,000; $30,000–$59,999; $60,000–$89,999; $$90,000; missing income), cigarettes smoked per day (,10, 10 to 19, $20), daily television viewing (,3 hours, $3 hours), respondent residence (New York City, Rest of New York state), and increases in state cigarette taxes. doi:10.1371/journal.pone.0102943.t003
Summary
Despite recent successes in reducing tobacco use, disparities in tobacco use and smoking cessation remain by race/ethnicity, education, income, and mental health status. Smoking prevalence is the same among black and white adults and lower among Hispanic adults [1], [2]. Health care providers are less likely to talk with black and Hispanic smokers and advise them to quit [3,4,5], and they are less likely to use effective cessation aids [3], [6], [7]. Hispanics and individuals who identify with more than one racial/ethnic group are more likely to have made a quit attempt than white smokers [8], and studies show no differences in quit success by race/ethnicity [9]. Education and income are strongly negatively associated with successful quitting [4], [13]
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